Provider Demographics
NPI:1699951707
Name:PEREIRA, MARTHA CARLOTA (APRN)
Entity type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:CARLOTA
Last Name:PEREIRA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9220 SW 72ND ST STE 206
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3259
Mailing Address - Country:US
Mailing Address - Phone:786-563-1550
Mailing Address - Fax:786-563-1551
Practice Address - Street 1:9220 SW 72ND ST STE 206
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3259
Practice Address - Country:US
Practice Address - Phone:786-563-1550
Practice Address - Fax:786-563-1551
Is Sole Proprietor?:No
Enumeration Date:2008-01-18
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9252828363LA2200X
FLAPRN9252828363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001807100Medicaid